Chapter 6: Drug Formulations & Patient Counseling Flashcards

1
Q

Which 5HT3-RA comes in a long-acting patch?

A

Granisetron

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2
Q

Which sweetener added to some drug formulations causes gas, cramping, and bloating in sensitive patients (i.e. patients with IBS)?

A

Sorbitol

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3
Q

Which sweetener is dangerous for those with phenylketonuria (PKU)?

A

Phenylalanine

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4
Q

What is the most commonly used excipient in drug formulations?

A

lactose

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5
Q

What should you instruct patients on when using granules, powders or capsules that can be opened and sprinkled into soft food and water?

A
  • Do not chew any long-acting pellets or beads that are emptied out from a capsule
  • Do not let the mixture sit too long if capsule contents are mixed in food or liquid
  • Do not add to anything warm or hot
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6
Q

T or F: you can crush or chew long-acting medications

A

false; this could lead to a fatal dose

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7
Q

What are osmotic release oral systems?

A

They provide fast drug delivery

followed by an extended release in one drug

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8
Q

What is an important counseling point about osmotic release oral systems (OROS)?

A

The tablet/shell may be visible in the patient’s stool (called a ghost tablet/capsule)

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9
Q

Why are long-acting medications used?

A
  • To avoid nausea or provide a long duration of action

- Reduces high “peaks” which reduces side effects

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10
Q

T or F: some long-acting opioid capsules can be opened and the contents sprinkled on certain foods

A

True

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11
Q

Which long-acting medications can be cut at the score line?

A

toprol XL

sinemet CR (carbodopa/levodopa)

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12
Q

Where on the body can patches be placed?

A

chest (upper)

back (upper and lower)

upper arm (on the part facing out)

flanks (sides of the body, abdomen level)

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13
Q

Where is Daytrana patch applied?

A

To the hip

alternating between right and left hip daily

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14
Q

Where is Transderm Scop patch applied?

A

Behind the ear

at least 4 hours before needed

alternating ears Q72H

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15
Q

Which patch can be cut into pieces?

A

Lidoderm

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16
Q

What happens if you apply heat to a patch?

A

Heat causes rapid absorption of the medication

17
Q

Which patches can be covered with adhesive film if it does not stick?

A

fentanyl (Duragesic)

buprenorphine (Butrans)

only with the permitted adhesive film dressings, Bioclusive or Tegaderm

Catapres-TTS comes with its own adhesive cover

18
Q

T or F: you can flush some highly potent narcotic patches down the toilet to remove it from the home immediately?

A

True - these include

Duragesic
Butrans
Daytrana

19
Q

What are some counseling points for all monoclonal antibodies?

A

Do not shake the medication

avoid exposing the drug to extreme temperatures (hot or cold)

20
Q

How many times should a gel eyedrop be shaken prior to use?

A

once

21
Q

How long should you wait to use another medication in your eye after using an eye drop?

A

5-10 minutes

22
Q

How long should you wait to use a gel in your eye after using an eye drop?

A

10 minutes

23
Q

What should you do if your eye drop contains a preservative called benzalkonium chloride (BAK) and you wear soft contact lenses?

A

remove the lenses prior to administration

(wait 15 min to reinsert)

24
Q

When using eardrops on an adult, how would you pull the ear when administering?

For a child?

A

adult: up and back

child: down and back if < 3 years

25
Q

How long should you keep your ear facing up after administering an ear drop

A

5 minutes

26
Q

When would an ODT be useful

A

Patients with

dysphagia (difficulty swallowing)

children

nausea

vomiting

non-adherence

27
Q

Why would sublingual or buccal delivery with a tablet, film, powder or spray be useful

A

Has a faster onset of action & less drug is lost to gut deterioration & first-pass metabolism

28
Q

Singulair granules can be mixed in 5 ml baby formula or breast milk or:

A

Spoonful of applesauce

carrots

rice

ice cream

29
Q

Exelon patch is NOT applied to which part of the body that most patches can be placed

A

flanks (sides of body, abdomen level)

30
Q

How is lidocaine patch applied

A

1-3 patches

on for 12 hours

then off for 12 hours (as needed)

31
Q

How is nitroglycerin patch applied

A

On for 12-14 hrs

then off for 10-12 hrs

32
Q

When applying an eye drop, how long should you press down between your eye and the top of your nose after applying a drop

A

one full minute

33
Q

Patches that are applied daily

A

Daytrana patch - QAM, 2 hours prior to school

Nicotine (NicoDerm CQ) patch

Rivastigmine (Exelon) patch

Rotigotine patch

Selegiline patch

Testosterone patch - nightly (not on scrotum)

34
Q

Which two patches are applied Q72H

A

Fentanyl

Scopolamine

35
Q

Which patches are applied weekly

A

buprenorphine (Butrans)

clonidine

estradiol (Climara)

estradiol/levonorgestrel

36
Q

Which patches are applied twice weekly

A

estradiol (Alora, Vivelle-Dot)

oxybutinin (Oxytrol)

37
Q

Which patch is applied weekly for 3 weeks off for the 4th week

A

Ethinyl estradiol/Norelgestromin (Xulane)

38
Q

Which patch is applied twice daily

A

Diclofenac - (remember, di=2)